New rules aim to improve prior authorization process
Today, 88 percent of prior authorizations are conducted either partially or entirely manually. CAQH CORE has released the Phase V Operating Rules to strengthen the accuracy and trustworthiness of the prior authorization process and move the industry toward full automation.
The healthcare industry has made significant progress in adopting electronic transactions for common business practices. However, the lack of a standard for attachments has contributed to cumbersome processes for exchanging patient-specific medical information and supplemental documentation.
Integrated portal creates seamless transition between two CAQH Solutions
CAQH continues to make progress in improving provider directory data. Most recently, CAQH launched a new portal that streamlines access to provider directory data by integrating DirectAssure and CAQH ProView.
Participation in CAQH ProView for Groups Continues to Grow
Late last year, CAQH launched CAQH ProView for Groups to simplify the way data is shared between delegated provider groups and health plans. This first-of-its-kind functionality replaces the highly manual processes widely used today with an intuitive, efficient module within CAQH ProView.